Sara Gottfried, M.D. is a Harvard-trained, board-certified integrative physician, hormone expert, and yoga teacher in Berkeley, CA. Her medical practice is mostly virtual and features one-on-one and group wellness coaching for women internationally. She is the author of the forthcoming book, The Hormone Cure (Scribner/Simon and Schuster). Find her at http://www.saragottfriedmd.com/ or join the conversation at http://www.facebook.com/GottfriedCenter or http://twitter.com/DrGottfried and learn more about how to stay vital and energized from summer into fall as we head back to school.
This is the first in a series of articles that share the wisdom of Dr. Gottfried. The first is this story on energy boosters for back-to-school families juggling work and childcare duties.
What are the most common causes of low energy other than lack of sleep?
The most common causes of low energy I see, other than sleep debt, are adrenal burn out, thyroid problems, inauthenticity and unconscious aging. And some people have all four. Adrenal burn out has its roots in chronic stress states. Many folks in my integrative medicine practice have been overextended for years, maybe decades, first by careers, then by relationships, and often by parenting. There also is an epidemic of underdiagnosed thyroid problems, and the top two symptoms are fatigue and weight gain. Add in perimenopause and lack of understanding of your Great Purpose, and you’ve got a perfect storm for accelerated aging and fatigue. If you feel that there’s an aspect of your life that is “square-peg, round-hole,” you have an obligation to change it up before it harms you. This is not a complete list, but these are the most common root causes of fatigue that I’ve seen in my 10,000 patients over the past 10 years.
Anemia is a common source of fatigue but so is B12 deficiency and low thyroid. What kind of bloodwork can help pinpoint the cause of fatigue?
When I see a woman with fatigue, I spend 50 minutes asking about root causes such as those previously mentioned, along with questions related to low iron and gut health. Tests I recommend, depending on the client, include a Complete Blood Count, Comprehensive Metabolic Panel (adrenal burn out can increase your chance of pre-diabetes and diabetes), iron studies (ferritin is the most sensitive, and is often low if women with thyroid problems), cortisol and DHEAS (to check adrenal function), folate and B vitamins (yes, many people are low in B12 in particular and/or don’t absorb it well), thyroid, and testosterone. Even though men have much more testosterone than women, women are very sensitive to testosterone – plus it is the main hormone of vitality. That’s my initial panel but I would add a day 21 estrogen and progesterone in a woman with symptoms of estrogen dominance, to see if that might be contributing to excess blood loss with menstruation.
7 Tips for quick and natural energy boosts?
Getting kids back to school often feels stressful and overwhelming. As a mom of two kids and Harvard-trained doctor specializing in women’s vitality – that is, why vitality drops in women and what to do about it – I know the feeling. Out of necessity, I’ve become a scholar in how to optimize stressful transitions such as heading back to school from the halcyon days of summer.
I help women access their deeper reserves of energy and stay consistently vital during the back-to-school transition and throughout the exigencies of life. You’ll find that the byproducts of taking care of yourself pro-actively will include more joy, happier kids, and less toxic stress. And most of all, better energy and vitality.
1. Become a calendar dominatrix.Start with your year-at-a-glance (I have the vertical one from Amazon on the back of my family room door) and add all the school events, dentist and orthodontics appointments, back to school nights, and play dates. Every year I forget to schedule off from work for the inevitable “Parent Coffee Break” and other gatherings that I dread but end up enjoying. We need to reconnect with our community when we head back from the summer because it helps us adjust back to the school year and fills our tank, particularly if you are an extrovert. Now go through your monthly calendar and transcribe all the juice from the year-at-a-glance. Next get your daily calendar filled in, with every detail especially for the hardest transition, the first week back at school. When you manage your calendar proactively, you feel empowered. When the external schedule manages you, you feel overwhelmed and stressed. Make the energizing choice to manage your schedule before the first day of school.
2. Add white space.Now that you have your schedule in place, pencil in the white space, sacred space for increasing your energy. Don’t frame this as selfish; hold it as essential to optimizing your energy. I suggest 1 to 2 hours twice per week so that you have room to add in another yoga class, to run to the stationary store or soccer shop to get the thing you forgot, or to claim time to read a favorite book. What’s stressful and depleting during back-to-school is when you have no time for these inevitable tasks.
3. Change bedtime now. Every year I’ve waited until the night before school begins to get into the new bedtime routine. Not any more. My kids don’t get enough sleep, there’s more sibling rivalry and conflict in the house, and yet 80% is preventable by moving my kids’ and my bedtime earlier at least one week in advance, maybe two weeks. Create a new habit before the last night before school.
4. Plan the lunchbox.Get new ideas for school lunches and plan the grocery lists now. Engage your kids in the process – for instance, are they interested in Meatless Mondays, and the benefit to the planet and their health? How about picking a few yummy lunchbox recipes from Gwyneth Paltrow’s Goop site (http://goop.com/newsletter/81/en/)? Healthy food will help your kids prevent low blood sugar and attention problems, which will make parenting easier and help your energy.
5. Dump the junk.For many, myself included, summertime means ice cream and full glasses of chardonnay. Fatigue the first morning of school makes a big ol’ cup of regular coffee sound inescapable. Then you’re too juiced to sleep well. Change that up now, so that you don’t feel the brain fog of a sugar binge or the toxic effects of too much alcohol. Do you need a honeymoon before the start of the school year – to remove sugar, alcohol and gluten in advance of the first day of school? Cut back on caffeine and rely on true sources of energy rather than fake sources so that you feel your best. Caffeine raises cortisol, the main stress hormone, which thickens your waist, increases anxiety and disrupts sleep. True sources of energy include fresh seasonal vegetables chock full of antioxidants, enough protein (0.75 to 1.0 gram per pound of lean body mass), and the other self care such as exercise, yoga, meditation. Your body will reward you by clearing your mind.
6. Meditate.Before your eye skips to the next tip, let me say that meditation, in whatever form, makes me the patient mom I always wanted to be. Nothing fills my gas tank like focused attention and deep, diaphragmatic breathing. It has been shown to slow down aging by Novel Laureate Elizabeth Blackburn and reduce cortisol, the main stress hormone. It doesn’t have to be sitting rigidly on the floor in a corner of a shrine. It doesn’t have to be a 90-minute yoga class. It doesn’t have to be some complicated Sanskrit mantra. Here’s what my practice looks like: I wake up 20 minutes before my kids, make some tea, sit in the living room cross-legged and count my breaths. Or I write about what is on my mind. Or I enter “pigeon pose” with a forward fold for 5 minutes on one side, 5 minutes on the other side, and then rest in Sivasana for 5 minutes. Start your contemplative practice now – you’ll connect with a deep well that sustains your energy as you head back-to-school with your kids.
7. Smile.“Sometimes your joy is the source of your smile…but sometimes your smile can be the source of your joy,” teaches Thich Nhat Hanh. Smiling relaxes your jaw, which is where many of us trap stress and tension in our bodies. Extra credit for belly laughs!
This year, decline to lie in a puddle on the floor, depleted by the stress of heading back to school. Commit to doing it differently this year. Schedule in your white space, meditate in whatever form best suits you and smile – you’ll find your energy is better, consistently and reliably better, this year.